1. science
2. medicine
3. pediatrics

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American Academy of Pediatrics
A
District VIII Resident Newsletter
S P R I N G 2 0 0AAK,
9
AK,
YOUR REPS
David Tayloe
District Coordinator
[email protected]
Kathy Anderson
Asst. District Coordinator
[email protected]
INSIDE T HIS
ISSUE:
AZ, CO, HI, ID, MT, NV, NM, OR, UT, WA, WY, Uniformed Services West, Alberta,
WHAT’S THE ALF??
The Annual Leadership Forum (ALF) is one of the most exciting AAP meetings
of the year, and this year’s event took place February 12-15 in Chicago. The ALF
provides a primary communication link between the grassroots and policymaking
bodies of the AAP. The goals of the ALF include drawing upon multiple areas of
expertise within the Academy to advise and make recommendations to the Board
of Directors, promoting communication and networking among the leaders of
chapters, committees, councils and sections, incorporating diverse perspectives in
the discussion and debate of leading pediatric issues, providing leadership education for Academy volunteer leaders. Each state chapter is represented at the ALF
by its president, vice president and executive director. Committees, councils and
sections are represented by their chairpersons. The Section on Medical Students,
Residents and Fellowship Trainees (SOMSRFT) is represented by District Coordinators and the Section chairpersons.
The Resolution process
is an integral
component
of the ALF.
The Resolution process is an integral component of the ALF. The purpose of a
resolution is to provide a mechanism whereby the members of the Academy can provide input regarding Academy policies and activities. Any district, chapter, committee or section can submit a
resolution. Resolutions are introduced, discussed, and voted upon by attendees of the ALF. Those
resolutions that receive a majority vote are adopted; at this year’s ALF 72 Resolutions were introduced, and the debate over some became quite lively! Residents from District VIII authored two of
this year’s resolutions, and both of these proposals were adopted. The first resolution, entitled “PAT”
to Sleep: Pediatricians Against Television in the Bedroom, recommended that the AAP mobilize efforts to discourage the placement of TV’s in children’s bedrooms. Our 2nd resolution recommended
the adoption of a standardized fellowship application. Another successful resolution with important
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Residency in
Canada
2
Advocacy Corner
3
Air Evac Mission 4
Focus on Salt
Lake, Seattle
5
Your Program
Highlights
6
Rural Pediatrics: Get Out There!
Note: Author Dr. Sheila Idzerda is a pediatrician who practices in Bozeman, Montana. She is also the
Vice President of the Montana Chapter of the AAP. Many thanks for her contribution.
It’s 3PM on a Thursday afternoon in March. I am in
clinic with 14 children still to be seen. The call from
Labor and Delivery is unexpected. “The 26 week twins
will be delivering here?” What? I quickly learn that
this expectant mother is at 26 weeks with a known twin
pregnancy. The maternal transport team has arrived to
bring this mom-to-be to our closest hospital with a level
III nursery, 150 miles away, but labor has progressed
while they were en-route and now she is complete. My
Fresh Mountain Air in Montana
partner and I will be seeing these twins soon. I head to
the nursery to set up for the delivery. Luckily it is still day
shift so there are many willing hands to help. We set up the warmers, turn up the temperature in the operating room, arrange the resuscitation gear and have our monitors, surfactant
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Pediatrics: Still a Hot Ticket!
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Lots to Love about Peds!
Pediatrics continues to attract medical school graduates in large numbers, according to the resident
match conducted on March
19. In the largest match in
history, unprecedented
numbers of prospective
residents competed for
22,427 first-year positions
in a variety of specialties.
Only 1,087 positions were
unfilled, which illustrates
that the match is becoming
increasingly competitive for
US allopathic seniors, as
well as other groups.
Data from the National
Resident Matching Program
(NRMP) report that the
number of first-year pediatrics positions offered in the
2009
match
increased. Once again, over
97% of these positions were
filled by match applicants,
demonstrating that pediatrics continues to be a highly
desirable specialty for
medical school graduates. Of the 2,509 first-year
positions offered in pediatrics, 97.2% (2,440) were
Residency in Canada
Lindsay May MD, Program Delegate for Alberta, provides insight into residency training in Canada.
Canada and her Provinces
At the AAP National Conference
in October of last year, I felt
unique as one of only a few Canadian pediatrics residents in
attendance. In chatting with
many of the friendly American
residents in various pediatrics
programs, there were obvious
similarities in residency training
in the two countries. In general,
we share concerns about the
number of on-call hours, how
and when to choose a subspecialty, how much (or little) residents are able to shape their programs, and feel a bit stretched
with clinical duties, research,
family and friends, and our million other commitments! Despite all of this common ground,
I am pleased to provide a bit of
background into the structure of
Canadian pediatric residencies
and hope that if any of you may
be interested in visiting one of
the programs on elective or otherwise, that you seriously consider it!
There are 17 pediatric
residency programs in Canada
A MERICAN
A CA DEMY
OF
and they offer a total of 128
“Canadian” matched positions
and ten positions via the International Medical Graduate pathway. The Canadian Resident
Matching Service, otherwise
known as CaRMS, allocates
medical students and IMGs to
these positions in the stomachchurning process of the annual
CaRMS match. The Canadian
Association of Interns and Residents has representatives from
each province and works on the
“big picture issues” impacting
our residents, such as improving
the process of applying for fellowships. Each province (or
group of provinces) has a similar
organization to tackle equally
important but smaller scale issues. Our organization, the Professional Association of Residents of Alberta (PARA), is responsible for negotiating our
contracts including salary, oncall hours and scheduling, benefits, and time off for vacation,
maternity/paternity leave, and
educational leave.
P EDIA T RICS
filled, a slight increase from
96.3% (2,403 of 2,496 positions
offer ed)
in
2008. These numbers include first-year positions in
categorical pediatrics, as
well as combined programs
in pediatrics-dermatology,
pediatrics-emergency medicine, pediatrics-medical genetics, pediatrics-physical
medicine and rehabilitation,
pediatrics-psychiatry-child
psychiatry, and pediatricsprimary care.
“The
Royal College requires
that we complete at least
four years of pediatrics training
prior to writing
the licensing
exam.”
The Royal College
requires that we complete at
least four years of pediatrics
training prior to writing the
licensing exam. These four
years must include three years
of core paediatrics; the fourth
year varies. For those entering
general pediatrics, the fourth
year can be tailored toward
their future practice. If we
decide to subspecialise, there
are two options regarding that
fourth year. Some residents
opt to complete the three core
years of pediatrics and begin
their fellowship after that third
year. A potential disadvantage
is that the first year of fellow(Continued on Page 7)
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Advocacy Corner
Familias Fuertes in
New Mexico
Ananya Guha is a second year pediatric resident at the University of New
Mexico (UNM) in Albuquerque. During
her medical school training at the University of Florida (UF) she participated
in four medical trips to Ecuador and
Haiti and discovered her passion for
practicing primary/preventative medicine and for working with people in
underserved communities. While at
the UF, she developed curricula to
help Spanish-speaking migrant workers acquire the English skills needed
for a doctor’s visit and paired them
with medical students to role-play
those skills. As a resident at UNM she
received a Community Access to
Child Health (CATCH) grant to create
Familias Fuertes, a community health
program for families in the International
District, an impoverished Hispanic immigrant community in Albuquerque at an
increased risk of childhood obe-
sity. Familias Fuertes was developed through her Pediatric Advocacy, Rural, and Community (PARC)
elective at UNM. Familias Fuertes
curricula was developed in collaboration with Health Education and Nutrition graduate students at UNM. Recognizing family lifestyle as a major
component of childhood health,
Ananya strives to engage families in
exercising and eating healthy food
together, which encourages children
to model their parent’s healthy behavior. She is pictured centered in
the front row in a park with Familias
Fuertes participants.
- By Ananya Guha, PL-2, University
of New Mexico
A New Generation of Physician Leaders in Colorado
In an attempt to begin cultivating a
new generation of physician leaders;
residents and faculty at The Children’s Hospital Denver have recently
implemented an integrated advocacy education as part of their standard curriculum. The curriculum offers residents the chance to spend
half-days visiting WIC, working directly with community organizations,
and discussing healthcare reform
directly with State legislators. Now
entering the third month of the curriculum, residents have had overwhelmingly positive about the experiences.
Christy Smith a PL1 states,
“It was so great to see exactly what
happens at WIC and also was really
interesting hearing a healthcare bill
debated in the legislature”.
In addition to exposure
speaking directly to legislators, residents get a unique education about
Medicaid and SCHP directly from
members of the Colorado Office of
Healthcare Policy and Financing
(HCPF). Upon leaving this education
session, residents are intimately aware
of how Medicaid functions and also what
efforts are currently underway in Colorado to improve healthcare for kids.
Tri-County Health Department
The advocacy curriculum spans
the first 2 years of residency and also
includes 2 mandatory appearances at
the Colorado AAP’s legislative affairs
meeting and multiple debriefing sessions
with local pediatric advocates. These
opportunities are the first step toward
empowering residents at The Children’s Hospital Denver to be active in
the care of children from the clinic to
the State house with future plans to
create an intensive elective focusing
on honing advocacy and leadership
skills.
It is our hope at The Children’s
Hospital Denver that advocacy education becomes a crucial part of every
program’s resident curriculum, so if
anyone is interested in starting an advocacy program at their program feel
free to contact us by email.
Matt Rustici PL1 and Shawna Daake
PL1 ([email protected] and
[email protected])
Or our Advocacy Program Director, Dr.
A m y
S h r i v e r
M . D .
([email protected])
- By Matt Rustici, PL-1, University of
Colorado
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CATCH Grant: A Great Way to get Involved!
Want to get more involved in efforts in your community? The Community Access to Child Health (CATCH) Resident Funds program supports pediatric residents in the planning of community-based child health initiatives.
Grants of up to $3,000 are awarded twice each year on a competitive basis for pediatric residents to address the
needs of children in their communities. CATCH Resident Funds grant projects must include planning activities and
also may include some implementation activities. Resident grants are available twice a year—May to July, during
the CATCH Planning Funds grant cycle, and November to January, during the CATCH Implementation Funds
grant cycle. The next cycle of CATCH grants will open up on May 1, 2009, and applications will be due on July
31, 2009. Please contact your Chapter CATCH Facilitator and/or your District Resident CATCH Liaison to discuss
your ideas for a CATCH grant project and to obtain assistance with proposal development. The District VIII Resident CATCH liaison is Dr. Mary T. Rogers ([email protected]). For more information on CATCH and a listing of
past projects, please visit http://www.aap.org/catch/.
In 2008 six CATCH grants were awarded to residents from District VIII. “All Smiles for Nevada,” promoting oral
health by Shyama Kamat and Kami Larsen, U of Nevada. “Answering the Call: After-hours Access Assessment,”
assessing barriers to phone triage service among Spanish-speaking patients by Christine Derstine, Oregon.
“Autism Outreach for Rural Home Visits,” by Matthew Carter and Benjamin Hoffman, U of New Mexico. “Living the
Good Life,” obesity project by Cali Matheny and Mandy Allison, U of Utah. “Teen Parenting Education and Awareness,” by Adrienne Kurland and Rebecca Monk, Phoenix. “Wounded Warriors' Children - A Medical Home,” advocating for children of those in armed services, by Jennifer Knight and Elisabeth Stafford, San Antonio.
Congratulations to CATCH Grant Awardees!
Emergency Air-Evac Mission: Tripler-Japan-Texas
As a resident training in a military
facility, there are many unique opportunities. Especially as the only large
American medical center in the Pacific, Tripler Army Medical Center
provides medical support for humanitarian missions to Asia as well as for
air evacuations to the United States.
I was involved in an air-evacuation
mission of a 15 year-old male with
presumed diagnosis of Wegener’s
Granulomatosis. Our task was to
transfer the care of the patient from a
Japanese Children’s Hospital to our
military counterparts at Wilford Hall
in San Antonio, Texas. There was
quite an amount of coordination and
planning involved. The mode of
transportation best fit for our trip that
would involve traveling the “Great
Circle” - to cover as much land as
possible in the event of emergency
landing rather than crossing the Pacific Ocean- needed to be chosen. It
was decided that a KC131 refueler
jet would be ideal for the 14 hour trip.
I was reminded more than once that
we were flying in a large gas tanker
and not to plug any electronics prior
to getting permission, because a
spark could mean trouble! Our transport crew involved many highly
trained Critical Air Transport Team
members. Our patient was transported by helicopter to the air field by
both American and Japanese teams,
and we then secured him on board
the plane. We then began our long
journey. The view was beautiful and
the air was cold but invigorating.
Thankfully, our patient remained sta-
ble (sedated and intubated prior to
travel), except for a fever response
from one of his medications. We
safely transported him to San Antonio
where he resumed his wonderful medical care.
Hope you enjoy some of the pictures
from my mission!
- By Angela Lantang, PL-3, Tripler
Army Medical Center
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Focus on...Salt Lake City
Residents: 18 peds, 3 medpeds, 2 triple board and 1 child
neurology per year
Sites: Primary Children’s Medical
Center (PCMC), University of
Utah Medical Center (UUMC)
Fellowships: ER, PICU, NICU,
Endocrine, GI, Heme-Onc, ID,
Cardiology, and Genetics.
Dubbed one of the “best
places in America to live” by
Money Magazine, Men’s Health
and Outdoor Magazine, Salt
Lake has something for everyone. Its perks include sparse
traffic, sunny weather (over 200
days), proximity to the mountains, and myriad of outdoor activities. Residents enjoy pro basketball (Utah Jazz), AAA baseball
(Salt Lake Bees), the arts
(Sundance Film Festival), and a
great music scene.
As residents, we at Primary Children’s feel fortunate to
learn in a terrific program in a
safe place with quaint neighborhoods from which we can ride
our bikes to work or be at world
class ski resorts such as Alta,
Snowbird or Solitude in minutes.
The program is a diverse one
that includes people from all
over the country. If you ask any
one of us, we’ll tell you that one
of our favorite aspects of the
program is the close-knit nature
of our group. We enjoy hiking,
biking, skiing, backyard barbeques and themed parties together.
Our patient population
is from far and wide as well;
children from Utah, Colorado,
Nevada, Arizona, Idaho, Wyoming, and Montana are regularly seen at PCMC. Being the
only referral center for hundreds
of miles results in exposure to
rare and unique cases. Still, the
Utah program emphasizes primary care with 2 half-days of
clinic per week on non-ward
months. Upper level residents
can choose to turn that second
half-day into research time.
We enjoy great support
Focus on...Seattle
Downtown Phoenix
from our attendings, who
regularly bend over backwards
to help us out. Our input is
highly valued, and changes to
the program based on our ideas
have been known to happen
quickly.. For instance, there is a
yearly intern retreat weekend up
at Deer Valley, during which a
morning is spent coming up with
ways to change any problems
the interns might see in the system. The program director, Jim
Bale, is known to the residents
as a cross between Santa Claus
and Papa Smurf in his generosity, patience, care for our wellbeing, and ability to lead.
Never have I worked
somewhere where I have felt so
supported in all facets of my
growth. It is the unique combination of the wonderful learning
environment at PCMC and the
amazing natural environment in
Salt Lake City that make our
residency the extraordinary experience that it is.
“Have you ever had one of those crazy friends
who is always heading off to go rafting or
climbing or on some crazy mountaineering trip?
One who goes skiing in the morning, mountain
biking in the afternoon, and finishes off the day
with an evening snowshoe? You know the type - something of an ADHD outdoor enthusiast. If
that friend were a place, he would be Salt Lake
City.”
- Sam Hoxie, Hand Surgery Fellow, University of
Utah
- Megan Harrison, PL-2, University of Utah
weekends, people enjoy all of the outdoor fun that Washington has to offer—in the winter there are multiple ski areas as
well as snowshoe trails within 1-2 hours of Seattle. In the
summer, residents enjoy hiking trips and kayaking. During
intern orientation week, faculty members take the interns on
the Pinnacle Peak hike, near Mt. Ranier, where we learn
how to do ice ax arrests and glissade down the side of a
mountain. In a city with mountains to the east and west and
water all around, it is nearly impossible to be bored—the
hardest part is finding enough time in the midst of the busy
residency schedule to explore the many fun activities the
area has to offer!
UNIVERSITY OF WASHINGTON
Residents: 32 per year
Sites: Seattle Children’s, Harborview
Medical Center and U of Washington
Medical Center
Fellowships: Adolescent, Cards,
PICU, ER, Endo, GI, Academic Peds,
Genetics, Heme-Onc, ID, NICU, Nephrology, Neurodevelopment, Rheum
Our program is well
known for its commitment to rural
community pediatrics; each second year resident spends two
months working in a practice
somewhere in the WWAMI region (Washington, Wyoming,
Alaska, Montana and Idaho).
Unique aspects of our program
include: the WWAMI months, the
Medically Complex Child service,
Global Health and Community
Advocacy Pathway tracts and our
week-long intern retreat.
Seattle is divided into
many small neighborhoods, each
with its own personality. Most of
the residents reside in the northern half of Seattle, in Wallingford,
Ballard, Green Lake or the Uni-
5
Seattle Children’s
versity District, while some live south
of the lake in Capitol Hill. . Each of the
neighborhoods hosts its own weekly
farmer’s market, which promotes a
strong sense of community. Seattle is
a bike and pedestrian-friendly city with
multiple trails, making biking a safe
and fun option (if you don’t mind a few
hills!).
We residents are a busy
group. During the week, there are frequent class happy hours, journal
clubs, “Burgers on the Chiefs” and
informal clinic team gatherings. Since
most of our residents are transplants
to the Seattle area, we tend to socialize frequently outside of work. On the
- Lucie Turcotte, PL-2, University of Washington
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Your Program Highlights
ALBERTA: I’m writing this message from
under ten centimeters of fresh snow this
morning! It’s been a busy season for our
pediatrics program and the most significant update is that we have officially
passed the accreditation process. We
recently completed the Canadian Resi-
dency Match process and will soon be
welcoming ten new residents. Anne
Hicks, Faruqa Ladha, Laura Miles, Shabnam Minoosepehr, Aoife O’Carroll,
Melissa Paquette, Torrey Parker, Clare
Poschwatta, Lindsay Stockdale, and
Melissa Zelsman will be joining us in
July. In the mean time we’ve been enjoying the winter and finding many excuses
to get together for communal cooking
and eating!
ARIZONA: We are working on an advo-
cacy program to improve our screening
tools and cessation efforts for tobacco use in parents and adolescents.
Our program is very excited about the
Diamond Children's Medical Center,
opening ED services in July 2009
and the remainder in fall of 2010. Two
residents received grants for " barriers to
improving oral health in undeserved chil-
dren" and " Prevention of primary obesity
in children". The later one is ready to be
implemented in our continuity clinics in
the following months.
BRITISH COLUMBIA: It has been a
snowy winter in Vancouver but our residents have managed to make the most
of it with Winter Sports and evening gettogethers. New news in the program
would include the move to a night float
call system for the upcoming year. This
was a move heavily supported by the
residents and will be implemented on a
trial basis in the coming academic year.
Our senior residents are getting ready for
the Royal College exams. Dr. Kathryn
Leccese will be going to South Africa for
a year in the fall for her final year of pediatric training. This is an annual opportunity for residents at UBC as we have a
relationship with the Red Cross Hospital
in Cape Town.
COLORADO: Exciting updates from
Colorado!! Many of our graduating residents are heading out to remote areas to
help the rural community.
Colleen
Muzynoski (chief) to Billings, Montana,
Laura Brunner to rural Alaska, Michelle
Mills (chief) to Bend, Oregon, and John
Silverman and Liz Wolf (recently engaged!!) to Botswana.
The residentinitiated group “Finding Meaning in Medicine” has been moved to noon conference so that more residents could participate. We are proud to announce four
new additions to our residency family.
Ted Laetsch (chief) recently added twins
to his household. Courtney Patterson
and Meredith Schultz both gave birth to
boys.
NEVADA: Exciting news from Las Vegas... we have a new associate program
director, Dr. Kami Larsen. We are looking
forward to our new intern class. Our
graduating class has matched with the
following specialities: Paul Do, pulmonology, UC Irvine; Obiageri Ekeh, Neurology, Montefiore New York; Kanayo
Ezeanolue, NICU, Detroit; Neepa Gurbani, pulmonology, Cincinnati; Shyama
Kamat, ED, Miami; Jeremiah Nielson,
NICU, USC; Naseem Sulayman, PICU,
Cleveland. Our current chief resident,
Shruti Kant, has also matched in ED at
UAB.
NEW MEXICO: Our residents continue to
be at the forefront of child advocacy, both
through our PARC curriculum and their
own additional efforts. We had 2 CATCH
grants proposals submitted last round
and have 5 presentations at APPD and
PAS regarding our advocacy training
curriculum. Thomas Russell is the lead
author of a research article published in
the December 2008 edition of the Journal
of Pediatric Hematology and Oncology.
Molly Davis and Rebecca Rotello are
beginning a research study on the outcomes for infants with bronchiolitis on
home O2. Marie Gessel will be studying
policies on child restraint in newborn
units. Robin LeBlond is submitting her
nephrology research for publication.
Tina Petersen presented her neurology
research at national meetings. Molly
Davis and Kristian Goulet, are newly
engaged and will be getting married this
summer. Many of our graduating R3s
will be moving onto fellowship including
Thomas Russell and Clifford Gross
(Heme-Onc), Tom Fox (ID), Amy Garcia
and Aldo Maspons (GI), and Amber
Messier-Gieri (NICU). Amy Williams will
be working in Lesotho, Africa through the
Baylor Pediatric AIDS corp. Matt Carter
will be joining a pediatric practice in Salt
Lake City. Truc-Ha Duong will remain in
Albuquerque as a general pediatrician.
Jennifer Maito will remain at UNM as our
chief resident. Nicole Veitenheimer will
practice general pediatrics for a few
years before pursuing a neonatology
fellowship.
OHSU: Spring is coming at OHSU, along
with a new class of 13 fantastic residents
from Massachussetts to Arizona. We
have 3 proud mom-to-be's in the program. Advocacy projects remain strong,
with several residents accompanying the
Oregon Pediatric Society to the capital
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Your Program Highlights cont’d
for a successful lobbying day on child health
issues. Doug Lincoln will be attending the
AAP Legislative Advocacy Conference in DC
in April. April also brings our 2nd annual
Crawfish Boil (courtesy of the Southerners in
our program) and the start of Oregon's many
outdoor activities as the weather gets
warmer.
SAN ANTONIO: Residents from San Antonio Uniformed Services Health Education
Consortium (SAUSHEC) spent the Halloween weekend for our annual “Boondoggle”
teambuilding weekend. Friday’s events con-
sisted of a BBQ, trick or treating, and costume contest for the kids. Saturday was
spent with a morning competition between
classes for the annual Boondoggle driftwood
award. After the volleyball tournament, golf
ball frenzy, tarp war, and tug of war, the
class of 2009 was crowned winner for the 3rd
year in a row! The afternoon culminated in
an all out competition in “I survived a Japanese Game Show” style organized by Lt. Col
David Bush. M.D. The prize of a $50 gift
certificate for dinner/movie and a night of call
covered by our pediatric cardiologist, Dr.
Bush went to Capt Jeremy Granger M.D!
Once again all the residents of SAUSHEC
would like to thank our staff for covering the
hospital while we were away.
UTAH: Many residents have enjoyed outdoor activities like snowshoeing, crosscountry skiing, and especially alpine skiing.
Springtime in the valley has come a bit early
this year, and folks are starting to break out
the bikes again as well. The fun hasn't kept
us from our work. Nate Ostheimer, PL-1, is
applying for a CATCH grant to address the
needs of refugee communities in Salt Lake.
Clarisa Garcia and Kevin Nelson are also
applying for a CATCH grant that focuses on
smoking cessation and will look at pediatrician perceptions of patient and parent smoking. Jennifer Levin, also a PL-1, is applying
for a grant to fund a project looking at the
cytogenetics behind AML, correlating gene
mutations and phenotypic expression with
AML disease types. Ryan Donnelly and
Irene Kocolas, both PL-2's, have completed
a study entitled "The Effect of Pregnancy on
Aortic Growth Rate in Women with Marfan
Syndrome," which examines what is the
largest cohort of pregnancies in Marfan's to
date. A couple of other PL-2s, Erin Zinkhan
and Brook Lang, recently returned from Carmel, CA, where they presented at the Western Societies for Pediatric Research Conference. Leah Costello, PL-2 and Katie Glallagher, PL-3 and their CATCH grant "Healthy
Decisions for your Changing Body" has now
been accepted and will fund comprehensive,
culturally appropriate sexual education
classes for Latino adolescents and their parents. The travel bug has hit the residents in
Salt Lake.
Susana Williams, PL-4 and
Brooks Keeshin, PL-4 are in Nicaragua as I
write this, doing a four week rotation in Managua. Susana just returned from Africa,
where she and James Clements, PL-3 did a
ward rotation in a hospital in Eldoret, Kenya.
Katie Gllagher, PL-3 is heading off to Bali
and Heather Fremgen, PL-2 is making plans
to travel to Nepal from late March through
early May to do NRP teaching in a hospital
there. Matt Rubach, PL-2 is going to Dar Es
Salaam, Tanzania to help take care of kids
with cerebral malaria and enroll them in a
study to treat it. Finally, the stork has landed
here at the University of Utah peds program.
Andy Rose, PL-1 and his wife are expecting
their first baby this spring. Other residents
expecting include Angela DeLaO and Elizabeth Northrop. Shannon Murphy, PL-3, delivered her baby girl, Julia Ryan, on March 6.
Phil Isenberg’s (PL-3) wife delivered their
baby girl on March 5. Also, Brooke Johnston, PL-3 and her husband Andy celebrated
the arrival of their little bundle of joy, Emmett
Lewis Johnston, on February 14. Brooke
reports that Emmett "is going through cloth
diapers at the rate the hospital goes through
yellow gowns in RSV season." Congrats to
everyone!
WASHINGTON: We welcomed 2 new babies into our resident families this year with
a few more on the way. There are also many
weddings this spring, spread across all
classes. The Children's Health International
Medical Project of Seattle (CHIMPS) group
is again preparing to go on their medical
service trip to El Salvador in June and are
holding their annual auction this month to
raise funds. Everyone is happy to see the
rain and clouds subsiding and the sun returning--we were starting to think the mountains were a figment of our imaginations.
A BIG Thank You to all of our Program
Delegates for their contributions to this
article!
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Rural Pediatrics (cont’d from Page 1)
and epinephrine available. At just before 4PM “my” baby arrives. He is indeed tiny, approximately 800 grams; we
begin his resuscitation. I try and miss on the intubation, but the bigger problem is that he is so difficult to bag-mask
ventilate. My nurse begins chest compressions for his low heart rate. I try again on the intubation. Once he is intubated, it is still difficult to tell if I am in because his breath sounds are difficult to hear, but the anesthesiologist tells
me I am in, just give more pressure. Down the ET tube goes the epinephrine, and thankfully his heart rate
rises. Next, surfactant is given and he has a great response with much better air movement. We start decreasing the
oxygen supplementation given. At 15 minutes of age we are off to the nursery to further stabilize our little guy. My
wonderful partner’s baby has now arrived, and he is duplicating my efforts.
I arrive in the nursery, and the respiratory therapists are standing by with a ventilator. In addition, radiology
is waiting for me. As we get our tiny premie situated, I inquire about when the transport team will be arriving. “Well, that is the problem. We had to send the maternal transport team back (to the referral hospital) and the
helicopter is trying to turn around and come back with the neonatal team, but the weather has gotten really bad. We
don’t think they will be able to come for the twins.” Oh no. Nothing I can do about the weather or the transport
team, so I start placing a UAC and UVC and getting labs and xrays This 26 weeker is still mine for several more
hours at least.
Sound scary? Or exciting? How about both! I am a general pediatrician in private practice in a rural area of
Montana. That means that all of the things I trained to do in residency are still part of my daily repertoire of pediatric skills. While events like this delivery do not happen every day, especially with the snow storm thrown in, this is
the 3rd delivery of extremely preemie twins in the last year at our hospital. While we are far from a pediatric specialty hospital, I have great support here to provide good medical care. This is not 3rd world medicine. I love practicing here. I get to do all the things I trained to do, but more importantly I make a difference in the lives of the pediatric patients in our community. My partners and I are the specialists in pediatric care for a hundred mile radius
area. Do I think I saved this infant’s life? Well, yes I do and that is a great feeling. So if you want to make a very
real and concrete difference, consider rural pediatrics. And if the idea of both being both scared and excited appeals
to you, consider rural pediatrics. We need you here and in many areas across the country.
And the twins – still too early to tell as this happened last week, but they quickly got to CPAP, have started feeds
and have no evidence of IVH as of yet. They have a long road ahead, but I think I got “my” twin off to a pretty
good start.
Residency in Canada (cont’d from page 2)
ship is also spent studying for the difficult Royal College exam. Residents who have decided on a subspeciality relatively quickly seem best suited to this threeyear approach, because in this scenario fellowship
applications and reference letters should be prepared
November or December of second year! The other
option for subspecialists is to complete the fourth year
of core pediatrics and write the Royal College exam at
the end of that year, just prior to starting fellowship.
University of Alberta Residents enjoying some edible flow-
As for fellowship options, our
country is now in the process of
standardizing the fellowship
matching process so that residents
beginning a fellowship in 2011
will have common deadlines for
applications and interview schedules. At that time, the fellowship
positions will be allocated in a
match similar to CaRMS (in fact
it will be operated by the same
computer system) but will involve
multiple iterations and residents
will have the option to “hold” an
offer from a program temporarily
while other offers are made. At
the moment, each program has its
own deadlines and requirements
for fellowship applications, which
can present a challenge when we
time our electives and reference
letters.
That means
that all of
the things I
trained to
do in residency are
still part of
my daily
repertoire of
pediatric
skills
What’s the ALF??
(cont’d from page 1)
implications for residents recommended
that SOMSRFT (our section) 24 votes for
the AAP presidential election. This resolution actually was voted in the Top 10 and
will thereby receive special consideration
from the AAP Board. Stay tuned for news
of the outcome of this important resolution!
The ALF also featured a number of inspiring breakout sessions and seminars for its
attendees. Examples included “Tobacco
and Secondhand Smoke: Chapter Successes and Lessons,” “Engaging Young
Physicians in Chapter Activities,” and
“Building International Alliances and Collaborations.” On Saturday evening the
dinner talk, “From Rhetoric to RealityPediatrics Takes the Lead,” discussed the
passage of CHIP, implications of the
stimulus package for pediatrics, and other
current pediatric issues in the political
arena.
District Coordinator: David Tayloe, MD
University of Colorado Health Sciences Center
[email protected]
Assistant District Coordinator: Kathy Anderson, MD
University of Hawaii
[email protected]
Program Delegates:
Madigan Army Medical Center
Cathy Sampert: [email protected]
Naval Medical Center – San Diego
Alexandra Smith: [email protected]
Oregon Health & Science University
Doug Lincoln: [email protected]
Tripler Army Medical Center
Malia Shimokawa: [email protected]
University of Alberta Hospitals
Lindsay May: [email protected]
University of Arizona
Silvana Arciniegas: [email protected]
University of British Columbia:
Sadhana Balakrishnan: [email protected]
University of Colorado
Aline Bernard: [email protected]
University of Hawaii
Diane Pan: [email protected]
University of Nevada
Rosalie Kalili: [email protected]
Phoenix Children’s Hospital
Sahera Dirajlal: [email protected]
Beth Steffen: [email protected]
Dominic Moore: [email protected]
University of New Mexico
Clifford Gross: [email protected]
San Antonio Uniformed Services Health Education Consortium
Susan Hobernicht: [email protected]
University of Utah
Megan Harrison: [email protected]
St. Joseph’s Hospital & Medical Center
Agnes Bartha: [email protected]
University of Washington
Lucie Turcotte: [email protected]